Visual interpretations of sustainability: comparative approaches and introduction of an integrated model for the decision making

No hay un solo enfoque de la Sostenibilidad. Las diversas propuestas conceptuales pueden representarse gráficamente, de forma que cada modelo resultante plasma la importancia que el/la autor/a otorga a las diferentes dimensiones que configuran la sostenibilidad. La interpretación visual es un medio que ayuda a comprender mejor y perfeccionar el desarrollo de conceptos. Su aplicación a la Sostenibilidad aporta un valor añadido porque sintetiza conceptos, consolida enfoques y le otorga operatividad. Las propuestas de interpretación visual de la Sostenibilidad se basan, entre otras figuras espaciales, en los diagramas de Venn, en los círculos concéntricos y no concéntricos, en algunas propuestas geométricas como el triángulo de la sostenibilidad, y en las representaciones vectoriales. Los modelos están evolucionado al tiempo que lo hace la propia concepción teórica de la Sostenibilidad que se configura como un concepto multidimensional y multifuncional. En un inicio, las representaciones contemplaban las tres dimensiones básicas de la Sostenibilidad: social, medioambiental y económica. Progresivamente se ha ido incluyendo una cuarta dimensión, que puede variar de un autor a otro y que, en este caso, se identifica con la político-institucional, si bien también se van aceptando otras dimensiones como la cultural y la global. En este trabajo se comparan diversas propuestas de interpretación visual ya existentes para representar la Sostenibilidad y se presenta una nueva, de tipo vectorial, que incluye las cuatro dimensiones. Los/as autores/as presentan su modelo con un objetivo principal: ayudar a visualizar las interacciones y los procesos de sostenibilidad en la toma de decisiones relacionadas con el nuevo paradigma del desarrollo sostenible.There is no single approach to Sustainability. The several different conceptual proposals can be graphically represented in a way that each resultant model depicts the importance that the author(s) give to the different dimensions defining sustainability. Visual interpretation is a better way to help understand and enhance the concept of development. Its application to Sustainability contributes with a value added, since it synthesizes concepts, consolidates approaches and grants it with functionality. The visual interpretation proposals of Sustainability are based, among other spatial figures, on the Venn’s diagrams on concentric and non-concentric circles, on some geometrical proposals such as the sustainability triangle, and vector representations. Models and the own theoretical conception of Sustainability which is configured as a multidimensional and multifunctional concept are simultaneously evolving. In the beginning, representations included the three basic Sustainability dimensions: social, environmental and economic. Little by little, a fourth dimension has being included, which may vary from one author to another and that, in such case, it is identified with the political-institutional dimension, although other dimensions such as the cultural and global ones are also being accepted. In this paper, several visual interpretation proposals for Sustainability -already existent- are being compared. Yet, a new vector-type proposal which includes a fourth dimension is presented. The authors present this model with the primary objective of: helping to visualize sustainability interactions and processes in decision-making processes related to the new paradigm of sustainable development.Peer Reviewe

Interpretaciones visuales de la sostenibilidad: enfoques comparados y presentación de un modelo integral para la toma de decisiones

There is no single approach to Sustainability. The several different conceptual proposals can be graphically represented in a way that each resultant model depicts the importance that the author(s) give to the different dimensions defining sustainability. Visual interpretation is a better way to help understand and enhance the concept of development. Its application to Sustainability contributes with a value added, since it synthesizes concepts, consolidates approaches and grants it with functionality. The visual interpretation proposals of Sustainability are based, among other spatial figures, on the Venn’s diagrams on concentric and non-concentric circles, on some geometrical proposals such as the sustainability triangle, and vector representations. Models and the own theoretical conception of Sustainability which is configured as a multidimensional and multifunctional concept are simultaneously evolving. In the beginning, representations included the three basic Sustainability dimensions: social, environmental and economic. Little by little, a fourth dimension has being included, which may vary from one author to another and that, in such case, it is identified with the political-institutional dimension, although other dimensions such as the cultural and global ones are also being accepted. In this paper, several visual interpretation proposals for Sustainability -already existent- are being compared. Yet, a new vector-type proposal which includes a fourth dimension is presented. The authors present this model with the primary objective of: helping to visualize sustainability interactions and processes in decision-making processes related to the new paradigm of sustainable development

Differences in the immune response elicited by two immunization schedules with an inactivated SARS-CoV-2 vaccine in a randomized phase 3 clinical trial

BACKGROUND: The development of vaccines to control the COVID-19 pandemic progression is a worldwide priority. CoronaVac® is an inactivated SARS-CoV-2 vaccine approved for emergency use with robust efficacy and immunogenicity data reported in trials in China, Brazil, Indonesia, Turkey, and Chile. METHODS: This study is a randomized, multicenter, and controlled phase 3 trial in healthy Chilean adults aged ≥18 years. Volunteers received two doses of CoronaVac® separated by two (0-14 schedule) or four weeks (0-28 schedule). 2,302 volunteers were enrolled, 440 were part of the immunogenicity arm, and blood samples were obtained at different times. Samples from a single center are reported. Humoral immune responses were evaluated by measuring the neutralizing capacities of circulating antibodies. Cellular immune responses were assessed by ELISPOT and flow cytometry. Correlation matrixes were performed to evaluate correlations in the data measured. RESULTS: Both schedules exhibited robust neutralizing capacities with the response induced by the 0-28 schedule being better. No differences were found in the concentration of antibodies against the virus and different variants of concern between schedules. Stimulation of PBMCs with MPs induced the secretion of IFN-g and the expression of activation induced markers for both schedules. Correlation matrixes showed strong correlations between neutralizing antibodies and IFN-g secretion. CONCLUSIONS: Immunization with CoronaVac® in Chilean adults promotes robust cellular and humoral immune responses. The 0-28 schedule induced a stronger humoral immune response than the 0-14 schedule. FUNDING: Ministry of Health, Government of Chile, Confederation of Production and Commerce & Millennium Institute on Immunology and Immunotherapy, Chile. CLINICAL TRIAL NUMBER: NCT04651790

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

Visual interpretations of sustainability: comparative approaches and introduction of an integrated model for the decision making

No hay un solo enfoque de la Sostenibilidad. Las diversas propuestas conceptuales pueden representarse gráficamente, de forma que cada modelo resultante plasma la importancia que el/la autor/a otorga a las diferentes dimensiones que configuran la sostenibilidad. La interpretación visual es un medio que ayuda a comprender mejor y perfeccionar el desarrollo de conceptos. Su aplicación a la Sostenibilidad aporta un valor añadido porque sintetiza conceptos, consolida enfoques y le otorga operatividad. Las propuestas de interpretación visual de la Sostenibilidad se basan, entre otras figuras espaciales, en los diagramas de Venn, en los círculos concéntricos y no concéntricos, en algunas propuestas geométricas como el triángulo de la sostenibilidad, y en las representaciones vectoriales. Los modelos están evolucionado al tiempo que lo hace la propia concepción teórica de la Sostenibilidad que se configura como un concepto multidimensional y multifuncional. En un inicio, las representaciones contemplaban las tres dimensiones básicas de la Sostenibilidad: social, medioambiental y económica. Progresivamente se ha ido incluyendo una cuarta dimensión, que puede variar de un autor a otro y que, en este caso, se identifica con la político-institucional, si bien también se van aceptando otras dimensiones como la cultural y la global. En este trabajo se comparan diversas propuestas de interpretación visual ya existentes para representar la Sostenibilidad y se presenta una nueva, de tipo vectorial, que incluye las cuatro dimensiones. Los/as autores/as presentan su modelo con un objetivo principal: ayudar a visualizar las interacciones y los procesos de sostenibilidad en la toma de decisiones relacionadas con el nuevo paradigma del desarrollo sostenible.There is no single approach to Sustainability. The several different conceptual proposals can be graphically represented in a way that each resultant model depicts the importance that the author(s) give to the different dimensions defining sustainability. Visual interpretation is a better way to help understand and enhance the concept of development. Its application to Sustainability contributes with a value added, since it synthesizes concepts, consolidates approaches and grants it with functionality. The visual interpretation proposals of Sustainability are based, among other spatial figures, on the Venn’s diagrams on concentric and non-concentric circles, on some geometrical proposals such as the sustainability triangle, and vector representations. Models and the own theoretical conception of Sustainability which is configured as a multidimensional and multifunctional concept are simultaneously evolving. In the beginning, representations included the three basic Sustainability dimensions: social, environmental and economic. Little by little, a fourth dimension has being included, which may vary from one author to another and that, in such case, it is identified with the political-institutional dimension, although other dimensions such as the cultural and global ones are also being accepted. In this paper, several visual interpretation proposals for Sustainability -already existent- are being compared. Yet, a new vector-type proposal which includes a fourth dimension is presented. The authors present this model with the primary objective of: helping to visualize sustainability interactions and processes in decision-making processes related to the new paradigm of sustainable development.Peer Reviewe